COLFAX, CA - The foothills community of Colfax has learned Sutter Health has turned to an out-of-state business to print medical forms.

Colfax Mayor Donna Barklesaid GKM, a printing company, is one of the largest employers in Colfax. GKM lost their largest client, and will no longer be printing Sutter Health'shospital-based forms.

Sutter Health is moving their orders to a company out of state to cut down on costs.

"Right now, the health care industry nationwide is experiencing the most significant changes in nearly 50 years. These changes are ultimately good for patients," Sutter Health said in a statement. "They also require all businesses to reinvent themselves and find new and different ways to deliver high-quality health care at a lower overall cost."

The vice president of sales for GKMsaid management would not comment on the issue.

The human resources director of GKMsaid there would be more layoffs.

But there's no word if the company would be closing

"It's really sad for Colfax. We don't have much up here," said David Berlin, the son of a GKM employee.

"It's a shame that stuff is going away from the community. These small communities really need support," business owner Pete LoStritto said."A little town like this needs to keep people employed."

GKM has been working with Sutter since 2000. In 2010, GKM had 135 employees. Today, there are 73.